NPI | 1316050289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G76787) |
Additional Taxonomies | 208600000X Surgery (Licence: CA C76787) |
Enumeration Date | 2006-08-16 |
Last Update Date | 2019-07-01 |